The role of ultrasonography in the diagnostic criteria for rheumatoid arthritis and monitoring its therapeutic efficacy

Rheumatoid arthritis (RA) is a chronic systemic disease of connective tissue. It is characterized by symmetrical multiple joint involvement and extra-articular symptoms. Modern RA treatment methods place a particular emphasis on the earliest possible diagnosis and initiation of appropriate treatment. Currently, ultrasonography (US) is the key imaging test performed in RA patients. However, despite the general acknowledgement of its role in the assessment of disease activity, US was not included in the applicable ACR/EULAR criteria. This is due to the lack of strictly defined criteria for US evaluation and the interpretation of test results. In addition, the absence of a correlation between the common DAS/DAS28 disease activity score and ultrasound assessment of joints makes developing new diagnostic criteria difficult. The objective of this article is to review recent scientific reports on the use of ultrasonography in the diagnosis and monitoring of RA and to indicate current problems associated with the interpretation of test results and the comparison with applicable scores of disease activity.